From this article you will learn: what is a microinfarction, and how it differs from a classic heart attack. Causes, typical symptoms. Treatment and prognosis.
Contents of the article:
- The reasons for the microinfarction
- Treatment methods
- Rehabilitation after the transferred microinfarction
- Consequences and prognosis
Myocardial damage( cardiac muscle) in case of myocardial infarction can be different. The microinfarction is a small volume of the necrosis of the heart muscle that has arisen as a result of insufficient blood supply. Symptoms of a microinfarction in many respects resemble a clinic of a typical( large-hearted, widespread) heart attack, but they proceed somewhat easier, and in some cases it can pass in general asymptomatically.
But any infarct, even if small-focal, always represents a serious threat to the health and even the life of the patient. Therefore, the signs of acute shortage of myocardial blood always require an urgent examination, and in case of confirmation of the diagnosis of a heart attack, hospitalization is necessary for treatment in a hospital and subsequent long-term rehabilitation.
It is necessary to avoid frivolous attitude towards the diagnosis, since the prefix "micro-" means only the area of the lesion, but does not always indicate the same "light" degree of state. The focus of necrosis can be localized in the field of important structures of the heart muscle, and any infarction is very dangerous and requires careful examination, treatment by a cardiologist and observation.
But in general, the course of the microinfarction is much easier, and the forecast is relatively favorable - after the completion of the course of treatment and rehabilitation, it is possible to return the patient to work and an active lifestyle( with some recommendations and a few restrictions).
Causes of microinfarction
A microinfarct occurs as a result of ischemia or a lack of blood flow( compared to the norm) in the area of the heart muscle.
Ischemia may develop with:
occlusion of a coronary vessel( passing through the myocardium) with a thrombus or an atherosclerotic plaque;
acute spasm of coronary vessels.
Risk factors for myocardial ischemia and the occurrence of a heart attack( both small and large focal):
Angina( this is a form of chronic coronary heart disease), previously suffered myocardial infarction.
Arterial hypertension( high blood pressure).
Atherosclerosis and obesity, the consequence of which is the imbalance of lipids - a rise in blood concentrations of saturated fatty acids and a deficiency of polyunsaturated( omega-3 and omega-6 fatty acids).With atherosclerosis and excess weight, there are also prerequisites for clogging the coronary artery lumen with a detached atherosclerotic plaque or fat embol( a piece of free-circulating adipose tissue).
Smoking, including passive, often causes a spasm of the coronary vessels.
Male gender( after 50 years, the likelihood of a heart attack in women also increases).In men of any age and women in the post-menopausal period, hormonal background features( low amounts of estrogen) lead to increased clotting and risk of thrombosis.
Low training and low-activity lifestyle.
Psychoemotional stress - can cause spasm of the coronary vessels.
A significant physical load - can provoke the detachment of a plaque, a blood clot or a fat embol, aggravate the spasm of the coronary vessels.
Some chronic diseases, for example diabetes mellitus, in which the vascular wall suffers.
Characteristic symptoms of
The main signs of a microinfarction in most cases are no different from the symptoms of a large-heart attack. The severity of the condition of patients, the immediate and separated consequences are determined, mainly, by the amount of damage to the heart muscle.
Small-focal necrosis of the myocardium can occur in four versions:
Painful( typical) form - the symptoms resemble an attack of angina: burning pain behind the sternum or in the left half of the chest, giving( irradiating) to the left arm, shoulder, under the left scapula, to the neck. However, unlike angina, taking nitroglycerin can not completely stop pain and burning behind the sternum. In the future, lowering blood pressure, there is weakness, a "cold" sweat.
Asthmatic form - occurs as an attack of bronchial asthma and is accompanied by a feeling of lack of air, shortness of breath, pain in the heart is moderate or absent.
Abdominal form - with symptoms of an "acute abdomen": abdominal pain, often unbearable and painful, nausea, vomiting, due to which patients are often mistakenly hospitalized in the surgical or gastroenterological department.
Arrhythmic form, in which disturbances of rhythm and cardiac conduction appear in the foreground - in the form of premature contractions of the heart, a sensation of interruptions, palpitations.
Asymptomatic form of the microinfarction
Symptoms of the microinfarction can be expressed very weakly( in the form of small, short-term gravity behind the sternum or shortness of breath) - this disease is called asymptomatic. Such a course of the disease is possible in persons with a reduced pain threshold, and also with a very small lesion. But, despite the fact that the signs of a microinfarction in this case do not cause trouble to the patient, this form can be more dangerous than clinically expressed ones - after all, the patient does not suspect that he has heart problems, which means that he does not consult a doctor and is not treated.
Microinfarction with asymptomatic course is often detected by chance, months and years after its occurrence - with routine clinical examination or ECG passage on another occasion. This "find" should be the reason for immediate appeal to the cardiologist - for a full examination of the cardiovascular system and the development of a patient rehabilitation program that will prevent relapse of myocardial ischemia and other unpleasant consequences. Do not forget that a once-suffered heart attack sharply increases the risk of a second heart attack, which can become fatal for you.
The main method of diagnosis of a microinfarct is electrocardiography( ECG).
In addition, a biochemical blood test is used( determining the markers of damage to the cardiac muscle - creatine phosphokinase, troponin, lactate dehydrogenase).
ultrasound of the heart( doppler echocardiography) allows you to clarify the location and size of necrosis.
Treatment of the microinfarction
If the microinfarction has occurred with typical symptoms and was diagnosed on time( in acute or acute phase, that is, within 2 hours to 10 days after its onset), treatment should be performed in a hospital, preferably in a cardiology unit where there isall conditions for a full examination and round-the-clock monitoring of the patient.
When classic signs of a heart attack appear - in the form of burning behind the breastbone with irradiation in the left arm - you should immediately call an ambulance, lie down and take a nitroglycerin pill under the tongue, you can also drink 1-2 tablets of aspirin. When the diagnosis is confirmed, the doctor will offer hospitalization and carry out other necessary measures( the administration of painkillers, including narcotic drugs, the onset of thrombolytic therapy, correction of blood pressure, heart rhythm, etc.).
. Inpatient administration continues the administration of painkillers, nitroglycerin, heparin and streptokinase( for the purpose of dissolving thrombi and preventing thrombus formation), using other medications according to indications.
In case the microinfarction was asymptomatic and was found accidentally, it is necessary to start rehabilitative measures.
Rehabilitation after the transferred microinfarction
Carrying out of rehabilitation measures after the transferred myocardial infarction allows to avoid development of adverse consequences, to accelerate the recovery period and to return activity and efficiency to patients.
Drug therapy and treatment of the underlying disease, against which a microinfarction arose, as well as the drug prevention of complications - taking aspirin, prolonged-release nitroglycerin and other drugs.
Restorative procedures - a gradual increase in physical activity by exercising exercise therapy with special training exercises, massage, physiotherapy, psychotherapy.
Proper nutrition with enrichment of foods rich in vitamins, vegetable fiber, polyunsaturated fatty acids( fish, vegetables and fruits, vegetable oil).At the same time, it is recommended to limit the use of refractory fats( butter, lard, animal fat) and salt.
Teaching the patient the regimen of the day, rest, relaxation techniques and ways to relieve stress.
Consequences and prognosis
Microinfarction with timely diagnosis and full treatment has a relatively favorable prognosis. The formed center of necrosis does not undergo reverse development: after a heart attack, a scar remains on the myocardium tissue. However, a balanced diet, adequate medication and metered exercise allow the patient to quickly recover and return to an active lifestyle.
There are no significant restrictions after a microinfarction on a patient - excessive physical exertion, nerve stresses are forbidden, and doctors strongly recommend to quit smoking. Regular examinations at the cardiologist and constant or course medicamental therapy are necessary.